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What is a Doula? A Doula provides emotional and physical support to mothers and families during their pregnancy and birth journey. A Dou...

Wednesday, 12 October 2016

DAY 2- OF THE 11TH INTERNATIONAL NORMAL BIRTH AND LABOUR CONFERENCE 2016

NORMAL BIRTH AND LABOUR CONFERENCE 2016



The second day of the conference was just as engaging as the first. I'll start from the very beginning because I hear it's a very good place to start.

Keynote Address by Professor Sally Tracy and Professor Alec Welsh

Holy schamoley- these two trailblazers basically introduced a whole new model of care in their Tertiary Hospital's maternity unit. Just casually of course. 

They used a woman-centered midwifery group practice model for both 'high' and 'low' risk women. The Obstetricians, Registrars (fresh doctors) and midwives had meetings weekly to ensure quality care.  This model exemplified continuity of care, which is essential for good outcomes. You go guys. 

Bonus quote: "Let's do what we can together to keep birth normal" - Alec Welsh

Yessir.


Professor Alec Welsh and Professor Sally Tracy 

And then Dr Andrew Bisits wooed the audience with his presentation on 'Can breech birth normal?'... hot tip. The answer is yes. 

He basically addressed 500 women who either were already in love with him, or are now. 


Fun facts from his talk: 

1. Birth workers can use every breech birth as an opportunity to learn about and therefore normalise breech birth. His groovy example was that even during a cesarean he lifts the baby from the womb in such a way as to show his Registrars how a breech would naturally arrive. 

2. He suggested that women were just as, if not more interested in how the baby manoeuvres during a breech birth than the statistics surrounding the decision making process. 

This is where it gets really good. 

A lovely Keynote speaker in the Audience, Bashi Hazard (who we hear from tomorrow... exciting!) asked Dr Bisits to explain to her, as though she were the mother, how the breech baby was born. 

He may as well have sung us all a breech lullaby. 

By the time he finished everyone was deadly quiet, as they had been hanging onto his every word. 

In the spirit of education I'll attempt to replicate what he said below... if you want the real deal I highly recommend seeing him at any future conferences/ chances you get. 


The Baby Women Whisperer


How does a breech baby come out? A Dr Bisits Breech Lullaby: abridged version. 

Everything moves down as a unit
Baby's bottom presses on the cervix, replicating the head
Cervix dilates at the same rate as head first
Once the Cervix is fully dilated and baby reaches mothers pelvic floor
One of the baby's hips move into the mother's pelvis
Mother gets a strong urge to push that hip under pubis bone
Then the baby comes down hip first, two steps forward one step back 
Get to point where it's two steps forward no steps back
That is bottom almost out
Which is good because babies' hips are same width as their head, you know baby won't get stuck if their head is tucked in
Once bottom is out, baby turns
-At this point bottom, body and arms are out
Then the woman feels a strong urge to push- even through contractions
This pushing is encouraged as this last stage should only last 3-4 minutes. 
Baby's head comes out 
Voila 
Baby is born. 


Dr Bisits went on to describe breech birth competence as a "fundamental and nonnegotiable item for midwives and obstetricians".  

It was all too much! We cheered. Then got tea. 

Rhea Dempsey wrote the book on pain dynamics in birth. I know, because I bought it today. 



Just hanging out with Rhea Dempsey. Everything is normal. 


Rhea's session on Pain Dynamics and Physiological birth had so many layers and so much truth to it. Like a truth cake... or truth haircut. Anyway- here are the quick highlights of what I took away: 

1. There are many different mindsets of women regarding their perception of pain during labour. At one end of the spectrum are women who do not want to experience it at all (orders the epidural before labour),  at the other are women who are keen to embrace the pain and arrange their birth environment and support people around that preference (home birth, birth centre). The majority of women are in between these two options. 

2. There are primarily two mindsets of labour ward midwives. They are either a working with pain midwife or a medicate pain midwife. This creates a problem for the majority of birthing women in the middle, as they don't know which midwife they will get. This can be seen in the woman who, during labour, decided that she really wanted an epidural but the midwife talked her out of it and as a result she was devastated; and the woman who had an epidural but didn't really want it, but had asked for it and then felt guilty about her decision. 

It's basically a communication breakdown which is leading to neither party knowing the mindset of the other, creating a difficult scenario when women reach their "crisis of confidence" points in their labour- wherever that may be. 


Here she is again. Because two pictures is better than one


The final keynote address of the day didn't leave a dry eye in the house. Or in my row of seats at least. Professor Sue Kildea and Leona McGrath's combined presentation addressed 'Birthing on Country, from Policy to Practice' and an 'Aboriginal Midwives perspective'. They also introduced us to Ranae Coleman, an Indigenous student midwife. 


L-R: Renae Coleman, Professor Sue Kildea, Leona McGrath.
A quick overview: 

1. They opened with a series of sobering statistics about maternal and infant mortality and morbidity for Indigenous compared to non-Indigenous Australians. Basically every statistic that I would hope would be the same, was twice as high, if not higher. 

2. They implored that culturally safe care is vital. 

3. Ranae Spoke about her journey to becoming an Indigenous student midwife, the difficulties she encountered and overcame along the way. **insert tears**

4. The importance of developing culturally safe stand alone birth centres in rural Indigenous communities was raised with the aim of improving cost effectiveness, health outcomes and provide spiritually safe care. However, at this point in time this seems like a pipe dream, as funding has not been granted- Professor Sue Kildea speculates that public involvement may amend this. 

Rally anyone?


Please take time to read the quote that Renae read to us.


"When you tell me ‘you don’t look Aboriginal’, you are denying that I am Aboriginal. To deny that I am Aboriginal is to deny that my grandmother was taken by welfare because she was Aboriginal, by the dictates of past government policies. To deny that she was taken because she was Aboriginal is to deny that past policies attempted genocide of Aboriginal people. To deny that the government’s objective was genocide is to deny that the government is responsible for the widespread decimation of Aboriginal language, traditions, land rights and intact family trees today. To deny that there is no widespread crises of identity within Aboriginal individuals, families, communities – and indeed our entire country – is to deny our lived reality. And when you deny our reality, you deny us our humanity. And so when you tell me ‘you don’t look Aboriginal’, it goes much further than just skin-deep." - Mykaela Saunders

The full article can be found here.



Thanks for reading you gorgeous thing! 



xxxxxx



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